Fast Five Quiz: Type 2 Diabetes and Coronary Heart Disease

Romesh Khardori, MD, PhD


April 24, 2023

Hypertension is common among individuals with type 2 diabetes and is a major risk factor for both ASCVD and microvascular complications. Current guidelines support a blood pressure goal of < 130/80 mmHg in people with diabetes. However, excessive blood pressure lowering, particularly in the presence of left ventricular hypertrophy or dysfunction, can potentially increase the risk for myocardial infarction because of a drop in coronary perfusion pressures across the diseased segments of the coronary arteries secondary to impairment of coronary autoregulation. Multiple trials have shown that a mean achieved blood pressure of < 120/80 mmHg may be associated with adverse cardiovascular outcomes, except for reduced risk for stroke, in patients achieving lower blood pressure values.

Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers are recommended first-line agents for hypertension in people with diabetes and coronary heart disease.

Learn more about cardiovascular risk reduction in patients with type 2 diabetes.


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